Provider Demographics
NPI:1053049411
Name:HENDREN, EMMA KAY (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:KAY
Last Name:HENDREN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 BENT TREE FOREST CIR APT 724
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-3414
Mailing Address - Country:US
Mailing Address - Phone:512-826-7743
Mailing Address - Fax:
Practice Address - Street 1:500 STRIBLING DR
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-2691
Practice Address - Country:US
Practice Address - Phone:817-444-4045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118747235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist